| چکیده انگلیسی مقاله |
Background: Discharge against Medical Advice (DAMA) indicate the dissatisfaction of patients with care services of health system. Additionally, it threatens patient's life and causes negative financial outcomes for hospitals.
Objective: This study aimed to identify the causes of self-discharge decisions from the emergency department at Kowsar Hospital, Semnan, Iran.
Methods: This was a descriptive-analytical study conducted between August 2021 to March 2022. The data were collected by researcher-made questionnaire containing demographic characteristics and reasons for self-discharge, including three main concepts: personal, staff-related factors, and environmental factors with sub-concepts. Data were analyzed using SPSS.
Results: Totally, of 140 patients with mean age of 33.52 ± 16.17 years, 58.6% were men and 41.4% were women. Moreover, 63.6% of patients were married, 42.1% had diploma education, and 11.4% had a history of taking neuropsychiatric drugs. Also, 42.9% of patients were covered by social security insurance. The highest rate of self-discharge was in the evening (42.1%) and night (37.9%) shifts. The most important reasons for self-discharge decision were problems related to insurance (30%), COVID-19 infection (26.4%), poor communication (17.1%), dissatisfaction with care (15.7 %), disrespectful behavior of staff (12.9%), and inappropriate emergency ward facilities (12.1%).
Conclusion: Taking appropriate decisions to improve the quality of medical services and increase cooperation in health insurance, separating the departments of infectious diseases away from other departments, holding briefing sessions for physicians and medical staff, increasing awareness of patients about possible complications of self-discharge, and improving the amenities of emergency ward can reduce the rate of self-discharge decision. |
| نویسندگان مقاله |
مهدی یاراحمدی | Mehdi Yarahmadi
Department of Emergency Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی سمنان، سمنان، ایران
مهری آیتی | Mehri Ayati
Department of Pediatrics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
گروه کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی سمنان، سمنان، ایران
محمد تقی قربانیان | Mohammad Taghi Ghorbanian
School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
دانشکده پزشکی، دانشگاه علوم پزشکی سمنان، سمنان، ایران
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